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. 2020 Nov 13;61:221–226. doi: 10.1016/j.jcrc.2020.11.004

Table 2.

Recommended contraindications for ECMO in centers facing resource constraints in the COVID-19 pandemica.

Relative contraindications
  • -

    Age ≥ 65

  • -

    Obesity (BMI ≥40

  • -

    Immunocompromised status

  • -

    No legal medical decision maker available

  • -

    Advanced chronic systolic heart failure

  • -

    High dose vasopressor requirement (not under consideration for V-A ECMO)

Absolute contraindications
  • -

    Advanced age

  • -

    Clinical Frailty Scale Category ≥ 3

  • -

    Mechanical ventilation >10 days

  • -
    Significant co-morbidities including:
    • o
      CKD ≥ III
    • o
      Cirrhosis
    • o
      Dementia
    • o
      Baseline neurologic disease precluding rehabilitation potential
    • o
      Disseminated malignancy
    • o
      Advanced lung disease
    • o
      Uncontrolled diabetes with chronic end-organ dysfunction
    • o
      Severe deconditioning
    • o
      Protein-energy malnutrition
    • o
      Severe peripheral vascular disease
    • o
      Other life-limiting medical illness
    • o
      Non-ambulatory status
  • -

    Severe multiple organ failure

  • -

    Severe acute neurologic injury e.g. anoxic, stroke

  • -

    Uncontrolled bleeding or contraindication to anticoagulation

  • -

    Inability to accept blood products

  • -

    Ongoing CPR

Abbreviations: BMI, body mass index; V-A, veno-arterial; ECMO extracorporeal membrane oxygenation; CPR, cardiopulmonary resuscitation.

a

Adapted from Extracorporeal Life Support Organization COVID-19 Interim Guidelines [30]